Harsh Thoughts: Cynicism Linked to Stroke Risk

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Middle-age and older people who are highly stressed, have
depression or who are perhaps even just cynical may be at
increased risk of stroke, according to new research.

In the study, more than 6,700 healthy adults ages 45 to 84
completed questionnaires about their stress levels, depressive
symptoms, feelings of anger, and hostility, which is a measure of
holding cynical views about other people. The researchers then
followed the participants for eight to 11 years, and looked at
the relationship between these psychological factors and people's
risk
of having a stroke.

"There's such a focus on traditional risk factors — cholesterol
levels, blood pressure, smoking and so forth. And those are all
very important, but studies like this one show that psychological
characteristics are equally important," said study researcher
Susan Everson-Rose, an associate professor of medicine at the
University of Minnesota in Minneapolis.

By the end of the study period, about 200 strokes had occurred.
The researchers found that people with high levels of cynicism
were more than twice as likely to have a stroke compared with
their less cynical counterparts.

The researchers also found that people with the most symptoms of
depression were 86 percent more likely to have a stroke during
the study compared with people with the lowest number of
depressive symptoms. Similarly, people who had chronic stress
were 59 percent more likely to have a stroke compared to
stress-free participants. [ 8
Tips for Healthy Aging ]

The researchers noted they did not find a link between feelings
of anger and increased risk of stroke.

The results of the study held even when researchers accounted for
known risk factors of stroke, including age, race, sex and health
behaviors, according to the study published today (July 10) in
the journal Stroke.

The findings suggest that psychological well-being, which has
already been
linked to heart health, also plays a role in stroke risk, the
researchers said.

A stroke happens when the brain does not receive enough blood,
due to the rupture of a blood vessel or a blockage in the
arteries. In the United States, stroke is the fourth leading
cause of death, and is a major cause of adult disability. About
800,000 people in the United States have a stroke each year,
according to the Centers for Disease Control and Prevention.

It's not entirely clear how stress and negative emotions affect
the heart or the brain, but emotions are shown to have metabolic,
hormonal and immune effects, the researchers said. People who
experience higher levels of stress,
depressive symptoms or hostility could experience changes in
their nervous or hormonal systems that, in turn, increase their
risk for stroke, the researchers said.

It is also possible that negative emotions affect health by
inducing inflammation, the researchers said.

People with high levels of stress and depression are more likely
to engage in unhealthy behaviors such as smoking and
excessive drinking, which would increase their stroke risk,
the researchers said. But in this study, the results didn't
change when the researchers accounted for people's smoking and
drinking habits, or their physical activity and blood pressure.